Being present

I've begun to realize (and acknowledge to myself) that I dissociate in a mild way in my sessions with my therapist more than I'd like. My anxiety goes up, I can feel a buzzing in my head, and I struggle to appear as if I'm all there, even when I'm not. I think I probably carry on without her noticing, as the conversation just continues. But in the meantime, I'm not processing anything that's being said.

How do those of you who dissociate to any degree deal with it in session? If I don't write down some of the contents of our sessions immediately afterward, I seem to forget about it rapidly.

I do it too. (disassociate) T. often "makes" me "come back" by having me feel my feet on the floor, my arms on the chair, etc. He asks me if I can be here, right here, right now. These mindfulness things help me. I never told him I was "going to my happy place (not really happy mostly numb-I know the buzzing brain you mention). He just seemed to know. And sometimes this assumes i want to be present (which I don't-no way no how) then sometimes we end up sitting quietly. But if you talked to T. she might be able to help you get "back" to the session. Just my experience for what its worth.

"If this is the present, I hope someone kept the receipt" :-)

I trained myself to put up a "red flag" when I was conscious of something going on that I couldn't deal with at the moment. Then, when I was alone later, often in bed before going to sleep that night, I'd go back to the red flag feelings and find I had "saved" more of what was going on then than I was aware of and could look at/deal with it and practice dialog with it, etc. and report back to my T next session. Over time in therapy I got better at being better able to deal in the moment and had fewer red flag moments and better coping abilities until, finally (7 years later), I could deal with everything that took place in session at the time it was happening.

I have this problem too. My t and i handle it in a couple of different ways. Sometimes, grounding reminders are enough to keep me in the present. At other times, if my emotions seem to be keeping overwhelming and i can't stay present, she will ask me if the hurt (or angry or scared) part of me needs to be put into a safe place so that the adult me can talk about it. (Often that is what needs to happen.) Or if i can, she will have the adult me stay present and picture the dissociating part of me sitting in a different chair and see if i can keep the awareness of both parts and engage in a dialogue between them.

This used to be a huge problem for me, but it has gotten better over time. My t is pretty good at not letting me draw too far into myself. He asks me to look at him. He has me describe concretely the things I see in the room, etc.

Thanks, sadden, Perna, and peaches for your responses.

Sadden, I'm impressed that your therapist is able to know when you're dissociating. Mine doesn't seem to be aware, though I admittedly try really hard not to allow her to be aware! And you make a good point that I might not always *want* to be present.

Perna, this:

made me LOL Your idea of using "red flags" is interesting to me. I'm aware in sessions when I'm drifting away, but it's hard to remember afterward what exactly went on during those periods. It's nice to hear that you were able to get to the point where you could cope with in-session stuff in your sessions!

Peaches, your therapist's techniques sound interesting. I tend to get confused when my therapist tries to have me speak to, or speak from, different parts of myself. But I haven't done it very much, either.

Oops, Chris, I missed your post. I started writing a response and then got called away from my computer for half an hour. I struggle with making consistent eye contact, but I'm getting better at it over time. I do think I'm more present when "forcing" myself to look at my therapist, but it's really difficult sometimes.

I struggle with this in therapy, a lot. Pretty much every time we talk about anything difficult, which is pretty much every session nowadays.

I know that in the beginning, my T wasn't aware that I was dissociating. I wasn't even aware of it myself. I've come a long way in recognizing it, and so has my T. I think, like you mobius, I was really good at hiding it and being able to continue with the conversation even if my mind wasn't all present. My T has learned to see the really subtle signs that I'm dissociating, and I've learned to tell her how I feel.

Sometimes I say "I'm not in my body" or "I can't feel my body" A lot of times my legs go numb, and I tell her that. But usually I'm fighting, really hard, to no just completely dissociate, and I'm counting on her to see that and to help me fight it. She tells me to open my eyes and keep breathing, since both closing my eyes and holding my breath seem to be ways I can push away the feelings in the moment. She gives me silly putty or something else to manipulate in my hands, or has me describe something in the room to her.

Great topic! I struggle with this one too, fairly typical, I think, even though it feels SO isolating. The topic of dissociation came up in session today- T reframed it as a 'creative coping strategy' rather than a negative symptom, which really just blew me away! I'm still chewing on that concept. Thanks for the great discussion.

I struggle with this a lot.

When I can feeling myself leaving and I want to stay present, I'll tell T "I feel floaty". When I just want to leave, I'll let myself go.

T will have me sit up straight (I think it usually happens when I'm laying down or curled into a little ball in the corner of the couch) and put my feet on the floor. I know sometimes I fight him on this and refuse to do it, and just let myself go. But, if I sit up and put my feet on the floor, he'll have me feel the rug under my toes (I always take off my shoes) and describe how things feel. He tries to get me to feel my toes, my feet, my legs, etc. He'll have me look around the room and describe things to him. Sometimes he'll have me drink water.

I know he's had me stand up and hold his hands and tell him things I can see.

Physical touch helps, so he will have me reach across and we'll touch fingers sometimes.

I know I used to just be GONE. Now I am able to stay present so much more, and I'm able to notice myself leaving and do the things T has me do - sit up, feet on floor, look at room, etc - on my own sometimes. When I do it on my own, T usually describes what I'm doing and encourages me: "you're looking at the familiar things on the wall..you're sitting up straight...you're doing a great job"

Therapy is SO HARD sometimes.

Mobius, are you going to discuss this with your T then? You can tell your T when you are starting to dissociate.

I "go away" in session. 6yrs ago I would remain stuck in it. T would gently say eventually, "where you gone now"? When I did "come too", the room would be to bright and my head to numb to speak.

With time this "going away" moments are less, I am able to "come back" sooner and most times speak about where it was I had gone. Not always. T never pushed me out of them because theres a reason for "going away", feelings to painful, suddenly remembering on a deep level. "going away" now is very familiar, I am able to sit with it and know I will "come back", it doesn't take me away so very far from my feelings now.

Yes, I did bring it up at the end of my last session. My therapist said she'd like to figure out a way for me to signal her when I'm dissociating. I'm just not sure if I can do that yet.

Tree, did your therapist initiate the idea of physical touch? I think it would be helpful for me too, but I'm terrified of asking for it.

I like that your therapist notices and encourages the times when you're able to do some of those things on your own. I find my therapist to be quite perceptive - she seems to notice a lot - but typically not the dissociating. I must just be that good

Hope I can join in the discussion.

Not sure if I dissociate or not but I too go away during my sessions. I have always wondered what happened and don't really know I'm gone untill I come back, if that makes any sense to anyone. Anyway when I come back the first thing I see is my T's eyes. It seems like he is right in front of me. When I see his eyes it's like I come too and know I'm in the room again. Sometimes I come too feeling different emotions but it's like I'm emotionally struggling between two worlds but don't really remember the other gone place.

I've wondered what was happening and what this was. Also I don't remember some parts of the sessions, it's fuzzy. When I go away it's just literally all the color black, like I'm just gone or agin I don't even know I was gone until I come back I don't know.

Actually, I read on here about people hugging their therapists and I asked him how he felt about physical touch with clients...because I wanted to make SURE I would never ever ever ever be touched. He told me that he does use touch - and gave me some examples - touching a hand, hugs, etc. He said that it was always discussed first, and he said that if it was something that the client wanted and that would be therapeutic for them, he feels like touch is an important part of being human, and there is a place for it in therapy.

A few months later, I had the first panic attack that I had ever had - IN session. I had been really, really triggered by something in a novel I was reading. I couldn't breathe and thought I was going to die - it was surreal and scary and awful. T did lots of things to help me - tried to get me grounded, talked about what was going on physiologically, brought me water, etc. At one point he handed me a marble to hold (he has a thing of marbles) and when he handed it to me, his fingertips brushed my palm. He asked me a few minutes later if I felt his fingers touch my palm and I said yes, and he asked if it was okay, and it really was, because everything was so spinny and awful I didn't care what happened. He asked if I wanted to try reaching across the room and touching fingertips and I said okay, so we reached across and touched our index fingers together.

Everything stopped spinning and I started to be able to be grounded. There was something about T's safe, solid presence, and being physically connected to it, that started to quiet things down inside.

There was a progression, and a lot of talk, and now (almost 3 years later), touch is a really comfortable and important part of my therapy. Sometimes T holds my hand, for connection, or grounding, or comfort, and we hug at the end of every session.

Just recently, I was having a really hard time in session, and T asked if I wanted to touch fingers across the room. We hadn't done that in SOOOOOO long, but we did, and it helped again. I like that he knows me so well.

SO! There is a REALLY long answer to a short question

What is holding you back?

When I'm really anxious, I get to the point where I feel frozen. It's not so much a matter of not wanting to, but rather, feeling too overwhelmed.

Hi Tree,

Thanks so much for your "long" answer I'm sorry it's taken me so long to respond. I've been feeling really overwhelmed in therapy, and it's been hard to think about it/write about it, and reading about others' therapy has become difficult for me all of a sudden. But I do really appreciate your willingness to share some of the details of your experience, and wanted to let you know that!

A couple of suggestions: Ask your therapist if she is open to hugs. If yes, it's a great way to end the session.

To come back to the room I use the 5 things that I see, 5 things that I hear, 5 things that I feel technique. You start with 5 things, then you go to 4,3 all the way to 1. - Describing what you see in the room, what you hear in the room and sensations you feel (even if you need to touch an object to describe how it feels.

Hope it helps.

what is dissociation? lately i've been having this feeling of "waking up" and suddenly realizing i'm somewhere. like all of a sudden i'm at the gym on the treadmill, and i think, "how did i get here?!" also, i feel like i'm in a dream sometimes. like my therapist is talking and i'm trying to focus on her and it feels like she's not real. are these two examples: dissociation? or if not, can anyone tell me what they are?

I like your suggestion, Robyn. Nice and concrete I'm in the midst of a 3-week vacation/sick break from therapy. I'm eager to get back, but also not, if that makes sense.

That sounds a lot like the experiences I have, seventyeight. I know that everyone dissociates to some degree. The example that's always given is driving from point a to point b without remembering how you got there. Our brains can function on "autopilot" for a time, especially with tasks that are overlearned. But the other type of dissociation (or I should say, somewhere else on the continuum of dissociation) that you describe seems to me to be more of a function of anxiety. When I approach anxiety-provoking territory (e.g., talking about my relationship with my therapist or certain aspects of my past), I get kind of fuzzy in the head and can't really focus very well, visually or in terms of the words I'm saying/taking in. There are two other concepts, which I think are also related to dissociation - depersonalization and derealization - where people feel as if they are watching themselves from the outside, and feel as if others and/or their surroundings aren't real, respectively. Sounds like you're maybe experiencing the latter?

What is it like in those moments with your therapist? Is she aware that you're having difficulties focusing?

no she has no idea. i just haven't mentioned it yet, it's only happened a few times but still. and it's not like we're talking about anything heavy, but yeah - she's gets all "fuzzy" and it feels like a dream. i thought maybe it was happening because i spend a lot of time thinking about therapy (so in a sense 'dreaming') and that's why when i'm there it was hard to tell the difference between that and reality. this is also why i haven't said anything - it's embarassing! thanks for all the info about it, that helps a lot. it's such a weird feeling, and very new to me.

Sounds like depersonalisation, a natural defence against feelings that may be painful whether consiously or unconsiously. I get it too.